Investigating the transition to home experience for people with mild stroke: the mild stroke transitional experience in Australia

Background: Stroke Coach is a lifestyle coaching telehealth program to improve self-management of stroke risk factors. Aims: To examine the efficacy of Stroke Coach on lifestyle behaviour and risk factor control among community-living stroke survivors within one-year post stroke. Methods: Participants were randomized to Stroke Coach or an attention control Memory Training group. Lifestyle behaviour was measured using the Health Promoting Lifestyle Profile II. Secondary outcomes included specific behavioural and cardiometabolic risk factors, health-related quality of life (HRQoL), cognitive status, and depressive symptoms. Measurements were taken at baseline, post-intervention (6 months), and retention (12 month). Linear mixed-effects models were used to test the study hypotheses (p<0.05). All analyses were intention-to-treat. Results: The mean age of the Stroke Coach (n=64) and Memory Training (n=62) groups was 67.2 and 69.1 years, respectively. The majority of participants (n = 100) had mild stroke (modified Rankin Scale = 1 or 2), were active, with controlled blood pressure (mean = 129/79 mmHg) at baseline. At post-intervention, there were no significant differences in lifestyle (b = -2.87; 95%CI -8.03 to 2.29; p=0.28). Glucose control, as measured by HbA1c (b = 0.17; 95%CI 0.17 to 0.32; p=0.03), and HRQoL, measured using SF-36 Physical Component Summary (b = -3.05; 95%CI -5.88 to -0.21; p=0.04), were significantly improved in Stroke Coach compared to Memory Training, and the improvements were maintained at retention. Conclusion: Stroke Coach did not improve lifestyle behaviour, however, there were improvements to HbA1c and HRQoL among community-living stroke survivors with mild stroke-related disability. (ClinicalTrials.gov identifier: NCT02207023)

Download Full-text

Psychometric evaluation of a newly developed measure of emotionalism after stroke (TEARS-Q)

Clinical Rehabilitation ◽

10.1177/0269215520981727 ◽

2020 ◽

pp. 026921552098172

Author(s):

Niall M Broomfield ◽

Robert West ◽

Allan House ◽

Theresa Munyombwe ◽

Mark Barber ◽

...

Keyword(s):

Item Response ◽

Psychometric Evaluation ◽

Self Report ◽

Stroke Survivors ◽

Reference Standard ◽

Stroke Units ◽

Post Stroke ◽

Response Variance ◽

Mild Stroke ◽

Functional Outcome Measures

Objective: To evaluate, psychometrically, a new measure of tearful emotionalism following stroke: Testing Emotionalism After Recent Stroke – Questionnaire (TEARS-Q). Setting: Acute stroke units based in nine Scottish hospitals, in the context of a longitudinal cohort study of post-stroke emotionalism. Subjects: A total of 224 clinically diagnosed stroke survivors recruited between October 1st 2015 and September 30th 2018, within 2 weeks of their stroke. Measures: The measure was the self-report questionnaire TEARS-Q, constructed based on post-stroke tearful emotionalism diagnostic criteria: (i) increased tearfulness, (ii) crying comes on suddenly, with no warning (iii) crying not under usual social control and (iv) crying episodes occur at least once weekly. The reference standard was presence/absence of emotionalism on a diagnostic, semi-structured post-stroke emotionalism interview, administered at the same assessment point. Stroke, mood, cognition and functional outcome measures were also completed by the subjects. Results: A total of 97 subjects were female, with a mean age 65.1 years. 205 subjects had sustained ischaemic stroke. 61 subjects were classified as mild stroke. TEARS-Q was internally consistent (Cronbach’s alpha 0.87). TEARS-Q scores readily discriminated the two groups, with a mean difference of −7.18, 95% CI (−8.07 to −6.29). A cut off score of 2 on TEARS-Q correctly identified 53 of the 61 stroke survivors with tearful emotionalism and 140 of the 156 stroke survivors without tearful emotionalism. One factor accounted for 57% of the item response variance, and all eight TEARS-Q items acceptably discriminated underlying emotionalism. Conclusion: TEARS-Q accurately diagnoses tearful emotionalism after stroke.

Download Full-text

Executive Dysfunction Immediately after Mild Stroke

OTJR Occupation Participation and Health ◽

10.3928/15394492-20101108-05 ◽

2011 ◽

Vol 31 (1_suppl) ◽

pp. S23-S29 ◽

Cited By ~ 10

Author(s):

Timothy J. Wolf ◽

Amy R. Barbee ◽

Desiree White

Keyword(s):

Executive Dysfunction ◽

Mild Stroke

Download Full-text

Changes in cognition following mild stroke

Neuropsychological Rehabilitation ◽

10.1080/09602011.2012.748672 ◽

2013 ◽

Vol 23 (2) ◽

pp. 256-266 ◽

Cited By ~ 16

Author(s):

Timothy J. Wolf ◽

Morgan C. Rognstad

Keyword(s):

Mild Stroke

Download Full-text

The Wayfinding Questionnaire as a Self-report Screening Instrument for Navigation-related Complaints After Stroke: Internal Validity in Healthy Respondents and Chronic Mild Stroke Patients

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acw044 ◽

2016 ◽

Cited By ~ 4

Author(s):

Michiel H. G. Claessen ◽

Johanna M. A. Visser-Meily ◽

Nicolien K. de Rooij ◽

Albert Postma ◽

Ineke J. M. van der Ham

Keyword(s):

Internal Validity ◽

Screening Instrument ◽

Self Report ◽

Stroke Patients ◽

Mild Stroke

Download Full-text

Psychometric Comparisons of 2 Versions of the Fugl-Meyer Motor Scale and 2 Versions of the Stroke Rehabilitation Assessment of Movement

Neurorehabilitation and Neural Repair ◽

10.1177/1545968308315999 ◽

2008 ◽

Vol 22 (6) ◽

pp. 737-744 ◽

Cited By ~ 64

Author(s):

I-Ping Hsueh ◽

Miao-Ju Hsu ◽

Ching-Fan Sheu ◽

Su Lee ◽

Ching-Lin Hsieh ◽

...

Keyword(s):

Stroke Rehabilitation ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Stroke Patients ◽

Chronic Patients ◽

Retest Reliability ◽

Intraclass Correlation Coefficients ◽

Mild Stroke ◽

Test Retest Reliability ◽

Rehabilitation Assessment

Objective. To provide empirical justification for selecting motor scales for stroke patients, the authors compared the psychometric properties (validity, responsiveness, test-retest reliability, and smallest real difference [SRD]) of the Fugl-Meyer Motor Scale (FM), the simplified FM (S-FM), the Stroke Rehabilitation Assessment of Movement instrument (STREAM), and the simplified STREAM (S-STREAM). Methods. For the validity and responsiveness study, 50 inpatients were assessed with the FM and the STREAM at admission and discharge to a rehabilitation department. The scores of the S-FM and the S-STREAM were retrieved from their corresponding scales. For the test-retest reliability study, a therapist administered both scales on a different sample of 60 chronic patients on 2 occasions. Results. Only the S-STREAM had no notable floor or ceiling effects at admission and discharge. The 4 motor scales had good concurrent validity (rho ≥ .91) and satisfactory predictive validity (rho = .72-.77). The scales showed responsiveness (effect size d ≥ 0.34; standardized response mean ≥ 0.95; P < .0001), with the S-STREAM most responsive. The test-retest agreements of the scales were excellent (intraclass correlation coefficients ≥ .96). The SRD of the 4 scales was 10% of their corresponding highest score, indicating acceptable level of measurement error. The upper extremity and the lower extremity subscales of the 4 showed similar results. Conclusions. The 4 motor scales showed acceptable levels of reliability, validity, and responsiveness in stroke patients. The S-STREAM is recommended because it is short, responsive to change, and able to discriminate patients with severe or mild stroke.

Download Full-text

A Comparative Study of Carotid Magnetic Resonance Plaque Imaging in Predicting the Early Progression of Acute Anterior Circulation Mild Stroke

Journal of Biomaterials and Tissue Engineering ◽

10.1166/jbt.2021.2664 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1113-1119

Author(s):

Bo Wei ◽

Yiqin Xu ◽

Xiaohong Gui ◽

Chenglong Wu ◽

Liping Wang

Keyword(s):

Carotid Arteries ◽

Plaque Imaging ◽

Plaque Composition ◽

Anterior Circulation ◽

Progressive Group ◽

Bilateral Carotid ◽

Early Progression ◽

Before And After ◽

3.0 T ◽

Mild Stroke

To analyze the biological properties of carotid lumen stenosis and plaque before and after bifurcation of the bilateral carotid arteries in patients with acute anterior circulation mild stroke (AACMS) by 3.0 T high-resolution magnetic resonance imaging (HR-MRI) with the aim to clarify the predictive effect of 3.0 T HR-MRI on early progression and poor prognosis in patients with AACMS. Random division of 96 patients with AACMS into a stroke progression group and a non-progression group. The bilateral cervical vessels of the patients were detected by HR-MRI. The degree of carotid artery stenosis before and after bilateral carotid bifurcation was evaluated using a vascular plaque imaging diagnostic system. There were significant differences in the maximum and average wall standardization index, maximum wall thickness, maximum wall area, plaque composition, proportion of plaque fibrous cap rupture, and proportion of VI complex plaques in the progressive group. There was no significant difference in the related indexes of bilateral vessels in the non-progressive group (P >0.05). There are significant differences in MRI morphological characteristics of bilateral carotid plaques in patients with AACMS progression. Through a comparative analysis of the plaque load and plaque composition of bilateral carotid arteries using 3.0 T HR-MRI in patients with early-stage AACMS, the type and stability of complex plaques can be identified, which serve as prognostic factors in predicting the early progression of stroke and guiding clinical treatment.

Download Full-text

Abstract W MP53: The Prevalence and Characteristics of Attention Disorders in The Patients with First-onset Mild Hemorrhagic Stroke

Stroke ◽

10.1161/str.46.suppl_1.wmp53 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Haruki Tokida ◽

Masakazu Nishigaki ◽

Masaru Kuriyama

Keyword(s):

Selective Attention ◽

Acute Phase ◽

Hemorrhagic Stroke ◽

False Negative ◽

Previous History ◽

Attention Deficits ◽

Stroke Patients ◽

Attention Disorders ◽

First Onset ◽

Mild Stroke

Objectives: Recent study revealed that over 50 % of stroke patients had some form of attention deficits. However, few reports focused on acute phase and mild stroke patients. This study aimed to investigate the prevalence of attention disorders and the change of their symptoms during the hospitalization in the patients with first-onset mild hemorrhagic stroke. Methods: Study subjects were 231 consecutive patients diagnosed as hemorrhage stroke and treated at our hospital from 2011 to 2012. Patients with severe hemorrhage (i.e., amount of bleeding >5cc), with previous history of cerebrovascular diseases or dementia, with decreased level of consciousness or with impaired activity of daily living were not eligible to this study. Neuropsychological assessments were conducted by speech therapists at 1 and 2 week after stroke onset using Clinical Assessment for Attention (CAT) and examined how they changed. CAT was a test battery developed by the Japan Society for Higher Brain Dysfunction to evaluate deficit of attention disorders. Results: Among the study subjects, 46 patients met the selection criteria and 16 patients (34.8%, 6 men, mean age was 66) were identified as having attention disorders. Bleeding lesions were left putamen (n=3), right putamen (n=9) and right thalamus (n=4). Significant improvements were observed in two types of focused attention and auditory selective attention measures: percentage of correct answers of Visual Cancellation Task (VCT, p=0.027) and Auditory Detection Task (ADT, p = 0.01). Additionally, working hours in VCT was significantly shortened, and the false-negative rate was also significantly decreased (p= 0.028). In ADT, the false-positive rate was significantly decreased (p= 0.012). No significant changes were observed in other type of tasks. Discussion: More than one-third of patients showed attention deficits even though they had mild stroke. Only focused and selective attentions were improved in acute phase of mild stroke. These results suggested that improvement in focused and selective attention precede improvement in other attentional functions.

Download Full-text